Lewis 49: Thyroid & Parathyroid Disorders
b
A 29-yr-old woman with systemic lupus erythematosus has been prescribed 2 weeks of high-dose prednisone therapy. Which information about the prednisone is most important for the nurse to include? a. "Weigh yourself daily to monitor for weight gain." b. "The prednisone dose should be decreased gradually." c. "A weight-bearing exercise program will help minimize risk for osteoporosis." d. "Call the health care provider if you have mood changes with the prednisone."
b
A 37-yr-old patient has just arrived in the postanesthesia recovery unit (PACU) after a thyroidectomy. Which information about the patient is most important to communicate to the surgeon? a. Difficult to awaken. b. Increasing neck swelling. c. Reports 7/10 incisional pain. d. Cardiac rate 112 beats/minute.
b
A 40-yr-old patient with suspected acromegaly is seen at the clinic. To assist in making the diagnosis, which question should the nurse ask? a. "Have you had a recent head injury?" b. "Do you have to wear larger shoes now?" c. "Is there a family history of acromegaly?" d. "Are you experiencing tremors or anxiety?"
d
A 44-yr-old female patient with Cushing syndrome is admitted for adrenalectomy. Which intervention by the nurse will be most helpful for the patient problem of disturbed body image related to changes in appearance? a. Reassure the patient that the physical changes are very common in patients with Cushing syndrome. b. Discuss the use of diet and exercise in controlling the weight gain associated with Cushing syndrome. c. Teach the patient that the metabolic impact of Cushing syndrome is of more importance than appearance. d. Remind the patient that most of the physical changes caused by Cushing syndrome will resolve after surgery.
b
A 56-yr-old patient who is disoriented and reports a headache and muscle cramps is hospitalized with possible syndrome of inappropriate antidiuretic hormone (SIADH). The nurse would expect the initial laboratory results to include a(n) a. elevated hematocrit. b. decreased serum sodium. c. increased serum chloride. d. low urine specific gravity.
c
A 62-yr-old patient with hyperthyroidism is to be treated with radioactive iodine (RAI). The nurse instructs the patient a. about radioactive precautions to take with all body secretions. b. that symptoms of hyperthyroidism should be relieved in about a week. c. that symptoms of hypothyroidism may occur as the RAI therapy takes effect. d. to discontinue the antithyroid medications taken before the radioactive therapy.
d
A nurse caring for a patient with hyperparathyroidism should monitor the patient for which complication? A. Seizures B. Cataracts C. Constipation D. Cardiac dysrhythmias
goiter
A nurse completes an assessment and notes that a patient's thyroid gland is enlarged. With which condition is this finding consistent?
bde
A nurse is caring for a patient admitted for hyperthyroidism. What laboratory results will the nurse expect to see in the electronic chart to confirm hyperthyroidism? Select all that apply. A. Elevated TSH level B. Undetectable TSH level C. Low free thyroxine (free T4) level D. Elevated free thyroxine (free T4) level E. Low thyroid-stimulating hormone (TSH) level
a
A patient being treated conservatively for hyperparathyroidism is being given discharge instructions. What statement made by the patient informs the nurse that the discharge instructions have been understood? A. "I should exercise regularly." B. "I should avoid excess dietary fiber." C. "I should restrict my fluids to 1000 mL daily." D. "I should report tingling in my hands and around my mouth."
b
A patient develops carpopedal spasms and tingling of the lips following a parathyroidectomy. Which action will provide the patient with rapid relief from the symptoms? a. Administer the prescribed muscle relaxant. b. Have the patient rebreathe from a paper bag. c. Start the PRN O2 at 2 L/min per cannula. d. Stretch the muscles with passive range of motion.
c
A patient diagnosed with hyperthyroidism received radioactive iodine one week ago. The patient tells the nurse, "I don't think the medication is working, I don't feel any different." What is the best response by the nurse? A. "You should notify your primary health care provider immediately." B. "You may need to have your thyroid removed sooner than anticipated." C. "It may take several weeks to see the full benefits of the treatment." D. "You don't feel any different? Would you like to sit down and talk about it?"
c
A patient has just arrived on the unit after a thyroidectomy. Which action should the nurse take first? a. Observe the dressing for bleeding. b. Check the blood pressure and pulse. c. Assess the patient's respiratory effort. d. Support the patient's head with pillows.
b
A patient has just begun long-term corticosteroid therapy. The nurse determines that the patient requires further education when making which statement? A. "I may need to monitor my blood sugar more frequently." B. "If I begin to gain weight I should stop taking my medication." C. "It is important that I stay away from people who have contagious illnesses." D. "I understand my appearance may change as fat tissue increases in my face and trunk."
de
A patient is admitted to the intensive care unit (ICU) with multiple organ abnormalities and a decreased level of consciousness. The nurse notes that the patient has a history of hypothyroidism. What interventions are appropriate to be included on the patient's plan of care? Select all that apply. A. Performing radiotherapy B. Using a high-pressure mattress C. Providing oxygen therapy D . Administering thyroid hormone intravenously E. Monitoring cardiovascular status continuously
b
A patient is admitted with diabetes insipidus. Which action will be appropriate for the registered nurse (RN) to delegate to an experienced licensed practical/vocational nurse (LPN/LVN)? a. Titrate the infusion of 5% dextrose in water. b. Administer prescribed subcutaneous DDAVP. c. Assess the patient's overall hydration status every 8 hours. d. Teach the patient how to use desmopressin (DDAVP) nasal spray.
c
A patient is being admitted with a diagnosis of Cushing syndrome. Which findings will the nurse expect during the assessment? a. Chronically low blood pressure b. Bronzed appearance of the skin c. Purplish streaks on the abdomen d. Decreased axillary and pubic hair
a
A patient is just returning to the surgical floor from the recovery room after undergoing a thyroidectomy. What is the nurse's priority nursing intervention? A. Have a tracheostomy tray at the bedside. B. Closely monitor the patient's emotional state. C. Avoid touching the patient's neck and shoulders. D. Maintain hydration status with small sips of water.
a
A patient is prescribed levothyroxine. To promote optimal absorption, the nurse should instruct the patient to take the medication at which time? A. 0600 B. 1200 C. 1600 D. 2100
c
A patient is scheduled for transsphenoidal hypophysectomy to treat a pituitary adenoma. During preoperative teaching, the nurse instructs the patient about the need to a. cough and deep breathe every 2 hours postoperatively. b. remain on bed rest for the first 48 hours after the surgery. c. avoid brushing teeth for at least 10 days after the surgery. d. be positioned flat with sandbags at the head postoperatively.
d
A patient reports "eye problems". On assessment of this patient, the nurse notes exophthalmos. What other abnormal assessments should the nurse expect to find in this patient? A. Puffy face, decreased sweating, and dry hair B. Muscle aches and pains and slow movements C. Decreased appetite and increased thirst and pallor D. Systolic hypertension and increased heart rate
c
A patient scheduled for a thyroidectomy is placed on potassium iodine. When the patient's family asks the nurse why this medication is needed, what is the nurse's best response? A. "This medication will promote thyroid hormone synthesis." B. "This medication will enhance healing following surgery." C. "This medication will decrease the vascularity of the thyroid gland." D. "This medication will inhibit the production of parathyroid hormone."
b
A patient was admitted to an inpatient unit for general weakness. The patient had laboratory tests completed, and the nurse is reviewing the results in the electronic medical record. The primary health care provider suspects hypothyroidism. The nurse recognizes that the patient is experiencing primary hypothyroidism. Which laboratory values support the suspicion of primary hypothyroidism? A. Low thyroid-stimulating hormone level, low thyroxine level B. High thyroid-stimulating hormone level, low thyroxine level C. Low thyroid-stimulating hormone level, low basal metabolic rate D. Low thyroid-stimulating hormone level, high basal metabolic rate
b
A patient who had a subtotal thyroidectomy earlier today develops laryngeal stridor and a cramp in the right hand upon returning to the surgical nursing unit. Which collaborative action will the nurse anticipate next? a. Suction the patient's airway. b. Administer IV calcium gluconate. c. Plan for emergency tracheostomy. d. Prepare for endotracheal intubation.
b
A patient who had radical neck surgery to remove a malignant tumor developed hypoparathyroidism. The nurse should plan to teach the patient about a. bisphosphonates to reduce bone demineralization. b. calcium supplements to normalize serum calcium levels. c. increasing fluid intake to decrease risk for nephrolithiasis. d. including whole grains in the diet to prevent constipation.
a
A patient who is diagnosed with hypothyroidism and coronary artery disease (CAD) states to the nurse, "I am constipated. My spouse wants me to try an enema to help relieve my discomfort." The nurse educates the patient that using enemas is contraindicated due to the diagnosis. Which is the rationale for this contraindication? A. Vagus nerve stimulation B. Olfactory nerve stimulation C. Abducens nerve stimulation
c
A patient who underwent thyroid surgery develops neck swelling. What is the first action that the nurse should take? A. Monitor calcium levels B. Evaluate difficulty in speaking C. Assess the patient for signs of hemorrhage D. Place the patient in a semi-Fowler's position
b
A patient who was admitted with myxedema coma and diagnosed with hypothyroidism is improving. Discharge is expected to occur in 2 days. Which teaching strategy is likely to result in effective patient self-management at home? a. Delay teaching until closer to discharge date. b. Provide written reminders of information taught. c. Offer multiple options for management of therapies. d. Ensure privacy for teaching by asking the family to leave.
b
A patient with primary hyperparathyroidism has a serum phosphorus level of 1.7 mg/dL (0.55 mmol/L) and calcium of 14 mg/dL (3.5 mmol/L). Which nursing action should be included in the plan of care? a. Restrict the patient to bed rest. b. Encourage 4000 mL of fluids daily. c. Institute routine seizure precautions. d. Assess for positive Chvostek's sign.
b
A patient's T3 and T4 levels are decreased, and the TSH (thyroid-stimulating hormone) level is increased. The nurse suspects what condition? A. Hypoparathyroidism B. Hypothyroidism C. Hyperthyroidism D. Hyperparathyroidism
a
Activity intolerance in a patient with hypothyroidism is related to what? A. Fatigue B. Diarrhea C. Weight loss D. Nervousness
c
After a patient with a pituitary adenoma has had a hypophysectomy, the nurse will teach about the need for a. sodium restriction to prevent fluid retention. b. insulin to maintain normal blood glucose levels. c. oral corticosteroids to replace endogenous cortisol. d. chemotherapy to prevent malignant tumor recurrence.
b
After receiving change-of-shift report about the following four patients, which patient should the nurse assess first? a. A 31-yr-old female patient with Cushing syndrome and a blood glucose level of 244 mg/dL b. A 70-yr-old female patient taking levothyroxine (Synthroid) who has an irregular pulse of 134 c. A 53-yr-old male patient who has Addison's disease and is due for a prescribed dose of hydrocortisone (Solu-Cortef). d. A 22-yr-old male patient admitted with syndrome of inappropriate antidiuretic hormone (SIADH) who has a serum sodium level of 130 mEq/L
c
An 82-yr-old patient in a long-term care facility is newly diagnosed with hypothyroidism. The nurse will need to consult with the health care provider before administering the prescribed a. docusate (Colace). b. ibuprofen (Motrin). c. diazepam (Valium). d. cefoxitin (Mefoxin).
c
An expected patient problem for a patient admitted to the hospital with symptoms of diabetes insipidus is a. excess fluid volume related to intake greater than output. b. impaired gas exchange related to fluid retention in lungs. c. sleep pattern disturbance related to frequent waking to void. d. risk for impaired skin integrity related to generalized edema.
bcd
An older adult patient who has a history of coronary artery disease (CAD) is diagnosed with hypothyroidism. What is appropriate for the nurse to include in the patient's education? Select all that apply. A. Eat a low-fiber diet. B. Avoid using enemas. C. Avoid using sedatives. D. Take the prescribed medication before breakfast. E. Alternate between the trade and generic brands of the medication.
b
In developing a teaching plan for the patient with exophthalmos, the nurse understands that the highest priority is placed on preventing ___ injury. A. nerve B. corneal C. retina D. pupil
b
The cardiac telemetry unit charge nurse receives status reports from other nursing units about four patients who need cardiac monitoring. Which patient should be transferred to the cardiac unit first? a. Patient with Hashimoto's thyroiditis and a heart rate of 102 b. Patient with tetany who has a new order for IV calcium chloride c. Patient with Cushing syndrome and a blood glucose of 140 mg/dL d. Patient with Addison's disease who takes hydrocortisone twice daily
b
The nurse admits a patient to the hospital in Addisonian crisis. Which patient statement supports the need to plan additional teaching? a. "I frequently eat at restaurants, and my food has a lot of added salt." b. "I had the flu earlier this week, so I couldn't take the hydrocortisone." c. "I always double my dose of hydrocortisone on the days that I go for a long run." d. "I take twice as much hydrocortisone in the morning dose as I do in the afternoon."
bce
The nurse anticipates that which interventions will be prescribed for a patient that is admitted to the intensive care unit (ICU) with myxedema coma? Select all that apply. A. Oxygen therapy B. Strict input and output C. Low-pressure mattress D. Oral thyroid medication E. Continuous cardiac monitoring
d
The nurse creates a plan of care for a patient with Graves' disease. What is an appropriate expected outcome? A. The patient will be free of infection. B. The patient will remain awake, alert, and oriented. C. The patient will be compliant with fluid restrictions. D. The patient will demonstrate maintenance of his weight.
a
The nurse determines that additional instruction is needed for a patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH) when the patient makes which statement? a. "I need to shop for foods low in sodium and avoid adding salt to food." b. "I should weigh myself daily and report any sudden weight loss or gain." c. "I need to limit my fluid intake to no more than 1 quart of liquids a day." d. "I should eat foods high in potassium because diuretics cause potassium loss."
b
The nurse determines that demeclocycline is effective for a patient with syndrome of inappropriate antidiuretic hormone (SIADH) based on finding that the patient's a. weight has increased. b. urinary output is increased. c. peripheral edema is increased. d. urine specific gravity is increased.
c
The nurse determines that the patient who is receiving radioactive iodine (RAI) therapy for the treatment of hyperthyroidism needs additional instructions when the patient makes which statement? A. "I will need to flush the toilet twice after I use it." B. "I should launder my laundry separately from those in my household." C. "I will need to take anti-thyroid drugs for 6 to 9 months after I begin RAI therapy." D. "If I develop a dry mouth I may gargle with a salt and soda mixture for relief."
c
The nurse expects that which medication will be included in the drug therapy for a patient that has a thyroxine level of 14 µg/dL? A. Natamycin B. Mirtazapine C. Methimazole D. Acetaminophen
b
The nurse is assessing a male patient diagnosed with a pituitary tumor causing panhypopituitarism. Assessment findings consistent with panhypopituitarism include a. high blood pressure. b. decreased facial hair. c. elevated blood glucose. d. tachycardia and palpitations.
a
The nurse is caring for a patient admitted with diabetes insipidus (DI). Which information is most important to report to the health care provider? a. The patient is confused and lethargic. b. The patient reports a recent head injury. c. The patient has a urine output of 400 mL/hr. d. The patient's urine specific gravity is 1.003.
c
The nurse is caring for a patient admitted with suspected hyperparathyroidism. Because of the potential effects of this disease on electrolyte balance, the nurse should assess this patient for what manifestation? A. Neurologic irritability B. Declining urine output C. Lethargy and weakness D. Hyperactive bowel sounds
abc
The nurse is caring for a patient being treated for acute thyrotoxicosis. What are the nursing interventions for this patient exhibiting exophthalmos? Select all that apply. A. Apply artificial tears. B. Tape the eyelids lightly for sleeping, if needed. C. Ask the patient to exercise the intraocular muscles. D. Place the patient in a supine position. E. Avoid elevating the patient's head.
b
The nurse is caring for a patient diagnosed with a toxic nodular goiter with painless thyroiditis. The nurse suspects that the patient has an autoimmune disease based on what assessment finding? A. Enophthalmos B. Exophthalmos C. Rounded rosy face D. Hypopigmentation
c
The nurse is caring for a patient following an adrenalectomy. The highest priority in the immediate postoperative period is to a. protect the patient's skin. b. monitor for signs of infection. c. balance fluids and electrolytes. d. prevent emotional disturbances
acd
The nurse is caring for a patient undergoing radioactive iodine therapy in the outpatient setting. What instructions should the nurse provide to this patient? Select all that apply. A. Avoid preparing food for others. B. Gargle with warm water before meals. C. Launder personal towels, bed linens, and clothes separately at home. D. Avoid being close to pregnant women or children for seven days after therapy. E. Discontinue antithyroid drugs after RAI therapy.
c
The nurse is caring for a patient who is postoperative following a thyroidectomy. A priority of the patient's nursing care includes which action? A. Assessment of hoarseness B. Assessment of Babinski's reflex C. Assessment of Chvostek's sign D. Assessment of neck full range of motion
b
The nurse is caring for a patient who received treatment for hypoparathyroidism and later developed hypocalcemia. Which is the goal of the treatment regimen for this condition? A. Increasing the pH B. Decreasing the pH C. Maintaining the pH D. Decreasing the calcium ionization level
a
The nurse is caring for a patient who underwent removal of the thyroid gland (thyroidectomy) three days ago. The patient's serum chemistries reveal calcium of 3.2 mg/dL, potassium of 3.9 mEq/L, and phosphorus of 4.0 mg/dL. What condition do these findings indicate? A. Hypocalcemia B. Hypercalcemia C. Hyperkalemia D. Hypophosphatemia
d
The nurse is caring for a patient with a history of hyperthyroidism who was admitted into the hospital with a kidney infection. It is most important that the nurse notify the health care provider if noting which physical sign or symptom? A. Flank pain B. Frequent voiding C. Heart rate of 100 beats/minute (bpm) D. Jugular vein distention
c
The nurse is caring for patients with thyroid cancer. The nurse recognizes that the one with the poorest prognosis is the patient with which type of cancer? A. Papillary thyroid cancer B. Follicular thyroid cancer C. Anaplastic thyroid cancer D. Medullary thyroid cancer
a
The nurse is performing discharge education for a patient who was admitted for acute hypothyroidism. The patient is undergoing thyroid hormone therapy for the first time. What statement by the patient to the nurse confirms that discharge teaching was effective? A. "I should take my levothyroxine every morning before eating my breakfast." B. "I should only follow up with my doctor if I start having shortness of breath." C. "I should keep the air conditioning a few degrees colder to help me with sweating." D. "I should limit the amount of fiber I am eating to help keep me from getting constipated."
b
The nurse is planning postoperative care for a patient who is being admitted to the surgical unit from the recovery room after transsphenoidal resection of a pituitary tumor. Which nursing action should be included? a. Palpate extremities for edema. b. Measure urine volume every hour. c. Check hematocrit every 2 hours for 8 hours. d. Monitor continuous pulse oximetry for 24 hours.
a
The nurse is teaching the patient and caregiver about managing hypothyroidism. What instruction should the nurse give the patient? A. Use soap sparingly. B. Avoid applying lotions to the skin. C. Use an enema if required. D. Reduce intake of dietary fiber.
c
The nurse provides a patient with a list of foods that fall under the category of goitrogens. What food item should be included on the list? A. Carrot B. Tomato C. Cauliflower D. Bell peppers
a
The nurse providing care for a patient who has an adrenocortical adenoma causing hyperaldosteronism should a. monitor the blood pressure every 4 hours. b. elevate the patient's legs to relieve edema. c. monitor blood glucose level every 4 hours. d. order the patient a potassium-restricted diet.
d
The nurse reviews lab values for a patient who underwent thyroidectomy 48 hours ago. Which finding is of most concern? A. Increased thyroxine B. Decreased phosphorus C. Increased serum calcium D. Decreased serum calcium
b
The nurse will plan to monitor a patient diagnosed with a pheochromocytoma for a. flushing. b. headache. c. bradycardia. d. hypoglycemia.
ace
The nursing care of a patient who had a parathyroidectomy should include which actions? Select all that apply. A. Monitor intake and output B. Monitor for Babinski's sign C. Ensure that intravenous (IV) calcium is available D. Instruct patient to maintain bed rest for 48 hours E. Assess for numbness and tingling of the hands and mouth
d
The patient experiencing thyrotoxicosis asks the nurse why he or she is being given propranolol. What is the most accurate answer to the patient's question? A. To suppress thyroid hormone secretion B. To prevent thyroid hormone induced hypotension C. To decrease thyroid gland vascularity in preparation for surgery D. To block the sympathetic nervous system response to excess thyroid hormone
0.5
The patient has a prescription for levothyroxine 37.5 mcg. Available are 0.075 mg tablets. How many tablets should the nurse administer?
ade
What are the characteristic signs and symptoms of hyperparathyroidism? Select all that apply. A. Fractures B. Tachycardia C. Hypotension D. Osteoporosis E. Nephrolithiasis
c
What does the nurse include in the teaching plan for the client who is receiving radioactive iodine? A. Private bathroom facilities are not necessary unless the patient is incontinent. B. Radioactive iodine therapy is contraindicated in women of childbearing age. C. Towels that are used by the patient should not be used by other family members. D. The patient should avoid being around pregnant women and children for 48 hours after treatment.
c
What is a nursing priority in the care of a patient with a diagnosis of hypothyroidism? A. Providing a dark, low-stimulation environment B. Closely monitoring the patient's intake and output C. Patient teaching related to levothyroxine D. Patient teaching related to radioactive iodine therapy
bcd
What should the nurse include in dietary instructions provided to a patient who is diagnosed with hyperthyroidism? Select all that apply. A. Eat a high-fiber diet. B. Consume a high-calorie diet. C. Eat snacks high in protein. D. Avoid caffeinated beverages. E. Decrease the intake of carbohydrates.
c
Which assessment finding for a 33-yr-old female patient admitted with Graves' disease requires the most rapid intervention by the nurse? a. Heart rate 136 beats/min b. Severe bilateral exophthalmos c. Temperature 103.8° F (40.4° C) d. Blood pressure 166/100 mm Hg
d
Which assessment finding of a 42-yr-old patient who had a bilateral adrenalectomy requires the most rapid action by the nurse? a. The blood glucose is 192 mg/dL. b. The lungs have bibasilar crackles. c. The patient reports 6/10 incisional pain. d. The blood pressure (BP) is 88/50 mm Hg.
c
Which clinical manifestation is a classic finding in Graves' disease? A. Gingivitis B. Cretinism C. Exophthalmos D. Muscular dystrophy
abd
Which clinical manifestations does the nurse expect to assess in a patient that is diagnosed with hyperthyroidism? Select all that apply. A. Weight loss B. Protrusion of the eye balls C. Thick, cold, and dry skin D. Elevated blood pressure E. Purplish red marks on abdomen
a
Which finding by the nurse when assessing a patient with Hashimoto's thyroiditis and a goiter will require the most immediate action? a. New-onset changes in the patient's voice b. Elevation in the patient's T3 and T4 levels c. Resting apical pulse rate 112 beats/minute d. Bruit audible bilaterally over the thyroid gland
d
Which finding by the nurse when assessing a patient with a large pituitary adenoma is most important to report to the health care provider? a. Changes in visual field b. Milk leaking from breasts c. Blood glucose 150 mg/dL d. Nausea and projectile vomiting
a
Which finding for a patient who has hypothyroidism and hypertension indicates that the nurse should contact the health care provider before administering levothyroxine (Synthroid)? a. Increased thyroxine (T4) level b. Blood pressure 112/62 mm Hg c. Distant and difficult to hear heart sounds d. Elevated thyroid stimulating hormone level
a
Which finding indicates to the nurse that the current therapies are effective for a patient with acute adrenal insufficiency? a. Increasing serum sodium levels b. Decreasing blood glucose levels c. Decreasing serum chloride levels d. Increasing serum potassium levels
d
Which information is most important for the nurse to communicate rapidly to the health care provider about a patient admitted with possible syndrome of inappropriate antidiuretic hormone (SIADH)? a. The patient has a recent weight gain of 9 lb. b. The patient complains of dyspnea with activity. c. The patient has a urine specific gravity of 1.025. d. The patient has a serum sodium level of 118 mEq/L.
c
Which information obtained by the nurse in the endocrine clinic about a patient who has been taking prednisone 40 mg daily for 3 weeks is most important to report to the health care provider? a. Patient's blood pressure is 148/94 mm Hg. b. Patient has bilateral 2+ pitting ankle edema. c. Patient stopped taking the medication 2 days ago. d. Patient has not been taking the prescribed vitamin D.
b
Which information will the nurse include when teaching a 50-yr-old male patient about somatropin (Genotropin)? a. The medication will be needed for 3 to 6 months. b. Inject the medication subcutaneously every day. c. Blood glucose levels may decrease when taking the medication. d. Stop taking the medication if swelling of the hands or feet occurs.
c
Which intervention will the nurse include in the plan of care for a patient with syndrome of inappropriate antidiuretic hormone (SIADH)? a. Encourage fluids to 2 to 3 L/day. b. Monitor for increasing peripheral edema. c. Offer the patient hard candies to suck on. d. Keep head of bed elevated to 30 degrees.
b
Which medication does the nurse expect to be prescribed for a patient diagnosed with metastatic thyroid cancer that has a calcitonin level of 25 pg/mL? A. Cisplatin B. Vandetanib C. Doxorubicin D. Cyclophosphamide
b
Which nursing action will be included in the plan of care for a patient with Graves' disease who has exophthalmos? a. Place cold packs on the eyes to relieve pain and swelling. b. Elevate the head of the patient's bed to reduce periorbital fluid. c. Apply alternating eye patches to protect the corneas from irritation. d. Teach the patient to blink every few seconds to lubricate the corneas.
b
Which nursing assessment of a 70-yr-old patient is most important to make during initiation of thyroid replacement with levothyroxine (Synthroid)? a. Fluid balance b. Apical pulse rate c. Nutritional intake d. Orientation and alertness
abd
Which nursing interventions are appropriate when providing care to a patient that is recovering from a thyroidectomy? Select all that apply. A. Assessing for tetany B. Monitoring vital signs C . Monitoring potassium levels D. Assessing the patient every two hours on the first postoperative day E. Placing the patient in a high Fowler's position
d
Which prescribed medication should the nurse expect will have rapid effects on a patient admitted to the emergency department in thyroid storm? a. Iodine b. Methimazole c. Propylthiouracil d. Propranolol (Inderal)
b
Which question will the nurse in the endocrine clinic ask to help determine a patient's risk factors for goiter? a. "How much milk do you drink?" b. "What medications are you taking?" c. "Are your immunizations up to date?" d. "Have you had any recent neck injuries?"